Provider Demographics
NPI:1033732763
Name:DORROUGH, AMBER NICOLE (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOLE
Last Name:DORROUGH
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3807 MCGINNIS DR
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-8816
Mailing Address - Country:US
Mailing Address - Phone:907-419-0650
Mailing Address - Fax:907-519-0555
Practice Address - Street 1:3807 MCGINNIS DR
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801
Practice Address - Country:US
Practice Address - Phone:907-419-0650
Practice Address - Fax:907-519-0555
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK168406163W00000X
WARN61186589163W00000X
MT212380163W00000X
ARR098179163WM0705X
AR212975363LF0000X
WAAP61186594363LF0000X
MT176690363LF0000X
VT101.0137441TELE363LF0000X
AK162977363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical